By Alan S. Peterson, MD
What is a bedsore?
A bedsore is a wound that happens when your skin rubs against an object (for example, bed sheets or a wheelchair) or when you don’t move for several hours. Bedsores are also called pressure ulcers. They usually happen on areas where a bone is close to the skin, like the tailbone, ankles, back, buttocks, elbows, heels, shins, and hips.
Who gets them?
Bedsores usually happen in people who have trouble moving, use a wheelchair, or can’t get out of bed. They are more likely to happen if you have diabetes, dementia, heart or kidney failure, low albumin or cancer.
How can I prevent them?
You should change positions at least every two hours and move around more if possible. Physical therapy may also help.
You or a caregiver should check for redness or sores on your skin. This will help to find bedsores early or perhaps to prevent them. Keep your skin from breaking down by changing the bed sheets and your undergarments often.
Your doctor may recommend using a special mattress or a device that protects your skin (for example, chair cushions or foam pads). Good nutrition also helps prevent bedsores. Tell your doctor if you are not eating well (at least one half of each meal).
What should I do if I get a bedsore?
Your doctor, and possibly a wound specialist, should examine it. We need a home caregiver to help you treat the wound. A caregiver can also help reposition you throughout the day if you have trouble doing it yourself. Tell your doctor if you are in pain.
How are bedsores treated?
A nurse or a home caregiver will clean and cover the wound with a dressing. The dressing must be changed often. Do not clean the wound with skin cleansers, like iodone, povidone (one brand: Betadine), or hydrogen peroxide. These and other skin cleansers may actually decrease the ability of your wound to heal quickly. Always follow your doctor’s instructions about caring for your wounds.
If your bedsore gets infected, your doctor may give you medicine. Sometimes oral antibiotics are indicated. Topical antibiotics can also be used. One should not use Neosporin as this can be a medication that causes skin allergies. Bacitracin or Polysporin are acceptable substitutes. Sometimes, surgery is needed to treat severe wounds.
One should always make sure that they are up to date with their tetanus immunizations. Bedsores can sometimes cause lockjaw from tetanus/organizms.
Where can I get more information?
Obviously your family physician is a fine source of information. Also the American Academy of Family Physicians at familydoctor.org. The Association for Advancement of Wound Care has another fine website at www.aawconline.org/patientresources.shtml. Another source of information is the National Institutes of Health at www.nlm.nih.gov/medlineplus/pressuresores.html.
Dr. Peterson is a doctor of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.